Review: Intensive Care by Gavin Francis
I finally finished a book in 2021! And it’s one with undeniable ongoing relevance. The subtitle is “A GP, a Community & COVID-19.” Francis, a physician who is based at an Edinburgh practice and frequently travels to the Orkney Islands for healthcare work, reflects on what he calls “the most intense months I have known in my twenty-year career.” He draws all of his chapter epigraphs from Daniel Defoe’s A Journal of the Plague Year and journeys back through most of 2020, from the day in January when he and his colleagues received a bulletin about a “novel Wuhan coronavirus” to November, when he was finalizing the book and learned of promising vaccine trials but also a rumored third wave and winter lockdown.
In February, no one knew whether precautions would end up being an overreaction, so Francis continued normal life: attending a conference, traveling to New York City, and going to a concert, pub, and restaurant. By March he was seeing more and more suspected cases, but symptoms were variable and the criteria for getting tested and quarantining changed all the time. The UK at least seemed better off than Italy, where his in-laws were isolating. Initially it was like flu outbreaks he’d dealt with before, with the main differences being a shift to telephone consultations and the “Great Faff” of donning full PPE for home visits and trips to care homes. The new “digital first” model left him feeling detached from his patients. He had his own Covid scare in May, but a test was negative and the 48-hour bug passed.
Through his involvement in the community, Francis saw the many ways in which coronavirus was affecting different groups of people. He laments the return of mental health crises that had been under control until lockdown. Edinburgh’s homeless, many in a perilous immigration situation thanks to Brexit, were housed in vacant luxury hotels. He visited several makeshift hostels, where some residents were going through drug withdrawal, and also met longtime patients whose self-harm and suicidal ideation were worsening.
Children and the elderly were also suffering. In June, he co-authored a letter begging the Scottish education secretary to allow children to return to school. Perhaps the image that will stick with me most, though, is of the confused dementia patients he met at care homes: “there was a crushing atmosphere of sadness among the residents … [they were] not able to understand why their families no longer came to visit. How do you explain social distancing to someone who doesn’t remember where they are, sometimes even who they are?”
Francis incorporates brief histories of vaccination and the discovery of herd immunity, and visits a hospital where a vaccine trial is underway. I learned some things about COVID-19 specifically: it can be called a “viral pneumonia”; it has two phases, virological (the virus makes you unwell) and immunological (the immune system misdirects messages and the lungs get worse); and it affects the blood vessels as well as the lungs, with one in five presenting with a rash and some developing chilblains in the summer. Amazingly, as the year waned, Francis only knew three patients who had died of Covid, with many more recovered. But in August, a city that should have been bustling with festival tourists was nearly empty.
Necessarily, the book ends in the middle of things; Francis has clear eyes but a hopeful heart. While this is not the first COVID-19 book I’ve encountered (that was Duty of Care by Dominic Pimenta) and will be far from the last – next up for me will be Rachel Clarke’s Breathtaking, out at the end of this month – it is an absorbing first-hand account of a medical crisis as well as a valuable memorial of a time like no other in recent history. A favorite line was “One of the few consolations of this pandemic is its grim camaraderie, a new fellowship among the fear.” Another consolation for me is reading books by medical professionals who can compassionately bridge the gap between expert opinion and everyday experience.
Intensive Care was published by the Wellcome Collection/Profile Books on January 7th. My thanks to the publisher for the free copy for review.
Gavin Francis’s other work includes:
Previously reviewed: Shapeshifters
Also owned: Adventures in Human Being
I’m keen to read: Empire Antarctica, about being the medical officer at the British research centre in Antarctica – ironically, this was during the first SARS pandemic. (In July 2020, conducting medical examinations on the next batch of scientists to ship out there, he envied them the chance to escape: “By the time they came home it would be 2022. Surely we’d have the virus under control by then?”)
Four Recent Review Books: Butler, Hunt, Paralkar and Vestre
Four February–April releases: A quiet novel about the clash of religion and reason; a birdwatching odyssey in London; a folktale-inspired story of the undead descending on an Indian medical clinic; and a layman’s introduction to fetal development – you can’t say I don’t read a wide variety of books! See if any of these tempt you.
Little Faith by Nickolas Butler
Butler follows in Kent Haruf’s footsteps with this quiet story of ordinary Midwesterners facing a series of small crises. Lyle Hovde works at a local Wisconsin orchard but is more interested in spending time with Isaac, his five-year-old grandson. Lyle has been an atheist since he and Peg lost a child in infancy, making it all the more ironic that their adopted daughter, Shiloh, has recently turned extremely religious. She attends a large non-denominational church that meets in an old movie theatre and is engaged to Pastor Steven*, whose hardline opinions are at odds with his hipster persona.
Steven and Shiloh believe Isaac has a healing gift – perhaps he can even help Lyle’s old pal, Hoot, who’s just been diagnosed with advanced cancer? The main story line reminded me most of Emily Fridlund’s History of Wolves (health and superstition collide) and Carolyn Parkhurst’s Harmony (the dangers of a charismatic leader). It’s all well and good to have faith in supernatural healing, but not if it means rejecting traditional medicine.
This is the epitome of a slow burner, though: things don’t really heat up until the final 35 pages, and there were a few chapters that could have been cut altogether. The female characters struck me as underdeveloped, but I did have a genuine warm feeling for Lyle. There are some memorable scenes, like Lyle’s heroic effort to save the orchard from an ice storm – a symbolic act that’s more about his desperation to save his grandson from toxic religion. But mostly this is a book to appreciate for the slow, predictable rhythms of a small-town life lived by the seasons.
[*So funny because that’s my brother-in-law’s name! I’ve also visited a Maryland church that meets in a former movie theatre. I was a part of somewhat extreme churches and youth groups in my growing-up years, but luckily nowhere that would have advocated foregoing traditional medicine in favor of faith healing. There were a few false notes here that told me Butler was writing about a world he wasn’t familiar with.]
A favorite passage:
“‘Silent Night’ in a darkened country chapel was, to Lyle, more powerful than any atomic bomb. He was incapable of singing it without feeling his eyes go misty, without feeling that his voice was but one link in a chain of voices connected over the generations and centuries, that line we sometimes call family. Or memory itself.”
With thanks to Faber & Faber for the free copy for review.
The Parakeeting of London: An Adventure in Gonzo Ornithology by Nick Hunt
Rose-ringed parakeets were first recorded in London in the 1890s, but only in the last couple of decades have they started to seem ubiquitous. I remember seeing them clustered in treetops and flying overhead in various Surrey, Kent and Berkshire suburbs we’ve lived in. They’re even more noticeable in London’s parks and cemeteries. “When did they become as established as beards and artisan coffee?” Nick Hunt wonders about his home in Hackney. He and photographer Tim Mitchell set out to canvass public opinion about London’s parakeets and look into conspiracy theories about how they escaped (Henry VIII and Jimi Hendrix are rumored to have released them; the set of The African Queen is another purported origin) and became so successful an invasive species.
A surprising cross section of the population is aware of the birds, and opinionated about them. Language of “immigrants” versus “natives” comes up frequently in the interviews, providing an uncomfortable parallel to xenophobic reactions towards human movement – “people had a tendency to conflate the avian with the human, turning the ornithological into the political. Invading, colonizing, taking over.” This is a pleasant little book any Londoner or British birdwatcher in general would appreciate.
With thanks to Paradise Road for the free copy for review.
Night Theatre by Vikram Paralkar
This short novel has an irresistible (cover and) setup: late one evening a surgeon in a rural Indian clinic gets a visit from a family of three: a teacher, his pregnant wife and their eight-year-old son. But there’s something different about this trio: they’re dead. They each bear hideous stab wounds from being set upon by bandits while walking home late from a fair. In the afterlife, an angel reluctantly granted them a second chance at life. If the surgeon can repair their gashes before daybreak, and as long as they stay within the village boundaries, their bodies will be revivified at dawn.
Paralkar draws on dreams, folktales and superstition, and the descriptions of medical procedures are vivid, as you would expect given the author’s work as a research physician at the University of Pennsylvania. The double meaning of the word “theatre” in the title encompasses the operating theatre and the dramatic spectacle that is taking place in this clinic. But somehow I never got invested in any of these characters and what might happen to them; the précis is more exciting than the narrative as a whole.
A favorite passage:
“Apart from the whispering of the dead in the corridor, the silence was almost deliberate – as if the crickets had been bribed and the dogs strangled. The village at the base of the hillock was perfectly still, its houses like polyps erupting from the soil. The rising moon had dusted them all with white talc. They appeared to have receded in the hours after sunset, abandoning the clinic to its unnatural deeds.”
With thanks to Serpent’s Tail for the free copy for review.
The Making of You: A Journey from Cell to Human by Katharina Vestre
A sprightly layman’s guide to genetics and embryology, written by Doctoral Research Fellow at the University of Oslo Department of Biosciences. Addressed in the second person, as the title suggests, the book traces your development from the sperm Leeuwenhoek studied under a microscope up to labor and delivery. Vestre looks at all the major organs and the five senses and discusses what can go wrong along with the normal quirks of the body.
I learned all kinds of bizarre facts. For instance, did you know that sperm have a sense of smell? And that until the 1960s pregnancy tests involved the death of a mouse or rabbit? Who knew that babies can remember flavors and sounds experienced in utero?
Vestre compares human development with other creatures’, including fruit flies (with whom we share half of our DNA), fish and alligators (which have various ways of determining gender), and other primates (why is it that they stay covered in fur and we don’t?). The charming style is aimed at the curious reader; I rarely felt that things were being dumbed down. Most chapters open with a fetal illustration by the author’s sister. I’m passing this on to a pregnant friend who will enjoy marveling at everything that’s happening inside her.
A representative passage:
“This may not sound terribly impressive; I promised you dramatic changes, and all that’s happened is that a round plate has become a triple-decker cell sandwich. But you’re already infinitely more interesting than the raspberry you were a short while ago. These cells are no longer confused, needy newcomers with no idea where they are or what they’re supposed to do. They have completed a rough division of labour. The cells on the top layer will form, among other things, skin, hair, nails, eye lenses, nerves and your brain. From the bottom layer you’ll get intestines, liver, trachea and lungs. And the middle layer will become your bones, muscles, heart and blood vessels.”
With thanks to Wellcome Collection/Profile Books for the free copy for review.
Would you be interested in reading one or more of these?
The Wellcome Book Prize 2019 Awards Ceremony
The winner of the 10th anniversary Wellcome Book Prize is Murmur, Will Eaves’s experimental novel about Alan Turing’s state of mind and body after being subjected to chemical castration for homosexuality. It is the third novel to win the Prize. Although it fell in the middle of the pack in our shadow panel voting because of drastically differing opinions, it was a personal favorite for Annabel and myself – though we won’t gloat (much) for predicting it as the winner!
Clare, Laura and I were there for the announcement at the Wellcome Collection in London. It was also lovely to meet Chloe Metzger, another book blogger who was on the blog tour, and to see UK book v/blogging legends Eric Karl Anderson and Simon Savidge again.
The judges’ chair, novelist Elif Shafak, said, “This prize is very special. It opens up new and vital conversations and creates bridges across disciplines.” At a time when we “are pushed into monolithic tribes and artificial categories, these interdisciplinary conversations can take us out of our comfort zones, encouraging cognitive flexibility.” She praised the six shortlisted books for their energy and the wide range of styles and subjects. “Each book, each author, from the beginning, has been treated with the utmost respect,” she reassured the audience, and the judges approached their task with “an open mind and an open heart,” arriving at an “inspiring, thought-provoking, but we believe also accessible, shortlist.”
The judges brought each of the five authors present (all but Thomas Page McBee) onto the stage one at a time for recognition. Shafak admired how Sandeep Jauhar weaves together his professional expertise with stories in Heart, and called Sarah Krasnostein’s The Trauma Cleaner a “strangely life-affirming and uplifting book about a remarkable woman. … It’s about transitions.”
Doctor and writer Kevin Fong championed Amateur, his answer to the question “which of these books, if I gave it to someone, would make them better.” McBee’s Canongate editor received the recognition/flowers on the author’s behalf.
Writer and broadcaster Rick Edwards chose Arnold Thomas Fanning’s Mind on Fire for its “pressability factor” – the book about which he kept saying to friends and family, “you must read this.” It’s an “uncomfortably honest” memoir, he remarked, “a vivid and unflinching window, and for me it was revelatory.”
Writer, critic and academic Jon Day spoke up for Murmur, “a novel of great power and astonishing achievement,” about “what it means to know another person.”
Lastly, writer, comedian and presenter Viv Groskop spoke about Ottessa Moshfegh’s My Year of Rest and Relaxation, which she described as “Jane Eyre meets Prozac Nation.” The judges “had a lot of fun” with this novel, she noted; it’s “caustic, feminist … original, playful, [and] strangely profound.”
But only one book could win the £30,000 10th anniversary prize, and it was one that Shafak predicted will be “a future classic,” Murmur. Will Eaves thanked Charles Boyle of CB Editions for taking a chance on his work. He also acknowledged Alan Turing, who, like him, attended King’s College, Cambridge. As he read Turing’s papers, Eaves reported, he was gripped by the quality of the writing – “there’s a voice there.” Finally, in a clearly emotional moment, he thanked his mother, who died several years ago and grew up in relative poverty. She was a passionate believer in education, and Eaves encouraged the audience to bear in mind the value of a state education when going to the polls.

Photo by Eric Karl Anderson.
After the announcement we found Sarah Krasnostein, our shadow panel winner, and got a photo and a signature. She gave us the scoop on her work-in-progress, which examines six case studies, three from Australia and three from the USA, of people with extreme religious or superstitious beliefs, such as a widow who believes her husband was abducted by aliens. She’s exploring the “cognitive dissonance” that goes on in these situations, she said. Can’t wait for the new book!

Laura, Sarah Krasnostein, me, Clare.
I also congratulated Will Eaves, whose book I’d covered for the blog tour, and got a signature. Other ‘celebrities’ spotted: Suzanne O’Sullivan, Ruth Padel and Robin Robertson. (Also a couple of familiar faces from Twitter that I couldn’t place, one of whom I later identified as Katya Taylor.)
I again acquired a Wellcome goody bag: this year’s limited-edition David Shrigley tote (I now have two so will pass one on to Annabel, who couldn’t be there) with an extra copy of The Trauma Cleaner to give to my sister.
Another great year of Wellcome festivities! Thanks to Midas PR, the Wellcome Book Prize and my shadow panel. Looking forward to next year already – I have a growing list of 2020 hopefuls I’ve read or intend to read.
See also: Laura’s post on the ceremony and the 5×15 event that took place the night before.
Two Records of Bodily Transformation: Amateur and Shapeshifters
Amateur: A True Story about What Makes a Man, Thomas Page McBee
Thomas Page McBee was the first transgender man to box at Madison Square Garden. In his second memoir, which arose from a Quartz article entitled “Why Men Fight,” he recounts the training leading up to his charity match and ponders whether aggression is a natural male trait. McBee grew up in a small town outside Pittsburgh with a stepfather who sexually abused him from age four. In 2011 he started the testosterone injections that would begin his gender transformation. During the years that followed, other men seemed to pick fights with him fairly often, and he was unsure what to do about it. Finally, in 2015, the Manhattan editor decided to confront the belligerent male stereotype by starting boxing training.
What I most appreciated were the author’s observations of how others have related to him since his transition. He notices that he’s taken more seriously at work as a man, and that he can be an object of fear – when jogging behind a woman at night, for instance. One of the most eye-opening moments of the book is when he realizes that he’s been talking over his own sister. Thankfully, McBee is sensitive enough to stop and change, recognizing that kindness and vulnerability are not faults but attributes any person should be proud of.
I have a feeling I would have preferred his previous memoir, Man Alive, which sounds like it has more about the transition itself. Jonathan Eig’s biography of Muhammad Ali is one of the best books I’ve read this year, and in comparison I didn’t find the boxing writing here very interesting. Likewise, this pales beside two similar but more perceptive books I’ve read that have been hugely influential on my own understanding of gender identity: Conundrum by Jan Morris and The Argonauts by Maggie Nelson.
My rating:
Amateur was published in the UK by Canongate on August 2nd. My thanks to the publisher for the free copy for review.
Shapeshifters: On Medicine and Human Change by Gavin Francis
Gavin Francis is a physician with a practice near Edinburgh. His latest book is like a taster course in medical topics. The overarching theme is the modifications the body undergoes, so there are chapters on, for example, body-building, tattoos, puberty, prosthetic limbs, dementia and menopause. Over his years in general practice Francis has gotten to know his patients’ stories and seen them change, for better or worse. These anecdotes of transformation are one source for his book, but he also applies insight from history, mythology, literature, etymology and more. So in a chapter on conception he discusses the Virgin Mary myth, Leonardo da Vinci’s fetal diagrams, the physiological changes pregnant women experience, and the case of a patient, Hannah, who had three difficult, surprise pregnancies in quick succession.
We are all in the process of various transformations, Francis argues, whether by choice or involuntarily. (I decided on the link with McBee because of a chapter on sex changes.) I was less convinced by the author’s inclusion of temporary, reversible changes such as sleep, hallucinations, jet lag and laughter. And while each chapter is finely wrought, I felt some sort of chronological or anatomical order was necessary to give the book more focus. All the same, I suspect this will be a strong contender for next year’s Wellcome Book Prize because of its broad relevance to human health and its compassionate picture of bodies in flux.
My rating:
Shapeshifters was published by the Wellcome Collection/Profile Books on May 2nd. My thanks to the publisher for the proof copy for review.
The Wellcome Book Prize 2018 Awards Ceremony
Hey, we got it right! Mark O’Connell’s To Be a Machine, our shadow panel’s pick, won the Wellcome Book Prize 2018 last night. Of the three shadow panels I’ve participated in and the many others I’ve observed, this is the only time I remember the shadow winner matching the official one. Clare, Paul and I were there in person for the announcement at the Wellcome Collection in London. When we briefly spoke to the judges’ chair, Edmund de Waal, later in the evening, he said he was “relieved” that their decision matched ours – but I think it was definitely the other way around!
Simon Chaplin, Director of Culture & Society at the Wellcome Trust, said that each year more and more books are being considered for the prize. De Waal revealed that the judges read 169 books over nine months in what was for him his most frightening book club ever. “To bring the worlds of medicine and health into urgent conversation” requires a “lyrical and disciplined choreography,” he said, and “how we shape stories of science … is crucial.” He characterized the judges’ discussions as both “personal and passionate.” The Wellcome-shortlisted books make a space for public debate, he insisted.

Judges Gordon, Paul-Choudhury, Critchlow, Ratcliffe and de Waal. Photo by Clare Rowland.
The judges brought each of the five authors present onto the stage one at a time for recognition. De Waal praised Ayobami Adebayo’s “narrative of hope and fear and anxiety” and Meredith Wadman’s “beautifully researched and paced thriller.” Dr Hannah Critchlow of Magdalene College, Cambridge called Lindsey Fitzharris’s The Butchering Art “gruesome yet fascinating.” Oxford English professor Sophie Ratcliffe applauded Kathryn Mannix’s book and its mission. New Scientist editor-in-chief Sumit Paul-Choudhury said Mark O’Connell’s book is about the future “just as much as what it means to be human in the twenty-first century.” Journalist and mental health campaigner Bryony Gordon thanked Sigrid Rausing for her “great honesty and stunning prose.”
But there can only be one winner, and it was Mark O’Connell, who couldn’t be there as his wife is/was giving birth to their second child imminently. The general feeling in the room was that he’d made the right call by deciding to stay with his family. He must be feeling like the luckiest man on earth right now, to have a baby plus £30,000! Max Porter, O’Connell’s editor at Granta and the author of Grief Is the Thing with Feathers, received the award on his behalf and read out the extremely witty speech he’d written in advance.
Afterwards we spoke to three of the shortlisted authors. Kathryn Mannix said she’d so enjoyed following our shadow panel reviews and that it was for the best that O’Connell won, as any other outcome might have spoiled the lovely girls’ club the others had going on during the weekend’s events. I got two signatures and we nabbed a quick photo with Lindsey Fitzharris. It was also great to meet Simon Savidge, the king of U.K. book blogging, and author and vlogger Jen Campbell. Other ‘celebrities’ spotted: Sarah Bakewell and Ben Goldacre.
This time I stayed long enough for pudding canapés to come around – raspberry cake pops and mini meringues with strawberries. What a great idea! On the way out I again acquired a Wellcome goody bag: this year’s tote with a copy of The Butchering Art, which I only had on Kindle before. I’d also treated myself to this brainy necklace from the Wellcome shop and wore it to the ceremony. An all-round great evening. I’m looking forward to next year’s prize season already!

Paul, Lindsey Fitzharris, Clare and me.